Russell B Jackson, OD is a
Optometrist based in Fillmore, Utah. Russell B Jackson is licensed to practice in Utah (license number 375344-9934) and his current practice location is
210 S 100 E, Fillmore, Utah. He can be reached at his office (for appointments etc.) via phone at
(435) 743-6572.
NPI number for Russell B Jackson is 1922008663 and his current mailing address is Po Box 73, Fillmore, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1922008663.
Healthcare Provider's Profile
Full Name | Russell B Jackson |
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Gender | Male |
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Speciality | Optometrist |
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Location | 210 S 100 E, Fillmore, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1922008663
- Provider Enumeration Date: 07/22/2005
- Last Update Date: 12/05/2007
Medical Identifiers
Medical identifiers for Russell B Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922008663 | NPI | - | NPPES |
37534499300001 | Other | UT | BLUE CROSS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 375344-9934 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Russell B Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Russell B Jackson, OD Po Box 73, Fillmore, UT 84631-0073 Ph: (435) 743-6572 | Russell B Jackson, OD 210 S 100 E, Fillmore, UT 84631-2500 Ph: (435) 743-6572 |
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